Fjölónæmir berklar á Íslandi : tilfellaröð og yfirlit

• Main Authors: Hilmir Ásgeirsson, Kai Blöndal, Þorsteinn Blöndal, Magnús Gottfreðsson
• Other Authors: Smitsjúkdómadeild Landspítala Fossvogi, Reykavík, [e-mail]
• Format: Article in Journal/Newspaper
• Language: Icelandic
• Published: Læknafélag Íslands, Læknafélag Reykjavíkur 2009
• Subjects: Berklar; Adult; Antitubercular Agents; Contact Tracing; Emigrants and Immigrants; Female; Humans; Iceland; Male; Mass Screening; Peritonitis; Tuberculous; Treatment Outcome; Tuberculosis; Multidrug-Resistant; Pulmonary; Young Adult; Maður; Smella
• Online Access: http://hdl.handle.net/2336/79917

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open BACKGROUND: Multidrug resistant tuberculosis (MDR-TB) is a growing health problem in the world. Treatment outcomes are poorer, duration longer and costs higher. We report three cases of MDR-TB diagnosed in Iceland in a six year period, 2003-8. CASE DESCRIPTIONS: The first case was a 23-year-old immigrant with a prior history of latent TB infection treated with isoniazid. He was admitted two years later with peritoneal MDR-TB. He was treated for 18 months and improved. The second case was a 23-year-old immigrant diagnosed with pulmonary MDR-TB after having dropped out of treatment in his country of origin. Clinical and microbiological response was achieved and two years of treatment were planned. The third case involved a 27-year-old asymptomatic woman diagnosed with MDR-TB on contact tracing, because of her brother's MDR-TB. 18 months of treatment were planned. CONCLUSIONS: Clustering of cases of MDR-TB in the last six years, accounting for almost 5% of all Icelandic TB cases in the period, suggests that an increase in incidence might be seen in Iceland in coming years. The infection poses a health risk to the patients and the general public as well as a financial burden on the health care system. Emphasis should be put on rapid diagnosis and correct treatment, together with appropriate immigration screening and contact tracing. Inngangur: Fjölónæmir berklar eru vaxandi vandamál í heiminum. Árangur meðferðar er verri, sjúkrahúslegur lengri og kostnaður hærri en við lyfnæma berkla. Hér er lýst þremur tilfellum fjölónæmra berkla sem greinst hafa á Íslandi síðastliðin sex ár, 2003-2008. Sjúkratilfelli: Fyrsta tilfellið var 23 ára innflytjandi frá Asíu sem lokið hafði fyrirbyggjandi meðferð vegna jákvæðs berklaprófs. Tveimur árum síðar lagðist hann inn með berkla í kviðarholi sem reyndust vera fjölónæmir. Hann lauk 18 mánaða meðferð og læknaðist. Annað tilfellið var 23 ára maður sem lagðist inn vegna fjölónæmra ...